Hospital Bills and Insurance

All patients should familiarize themselves with the terms of their insurance coverage. This will help you understand the hospital’s billing procedures and charges. If you have any questions about your bill, please call the Business Office at (937) 599-1405 or ext. 1405 from your hospital phone.


If You Have Health Insurance

We will need a copy of your health insurance identification card in order to process your registration. We also may need insurance forms, which are supplied by your employer or the insurance company. You will be asked to assign benefits from the insurance company directly to the hospital.


If You Are a Member of an HMO or PPO

Your plan may have special requirements, such as a second surgical opinion or pre-certification for certain tests or procedures. It is your responsibility to make sure the requirements of your plan have been met. If your plan’s requirements are not followed, you may be financially responsible for all or part of the services rendered in the hospital. Some physician specialists may not participate in your healthcare plan and their services may not be covered.
 

If You Are Covered by Medicare

We will need a copy of your Medicare card to verify eligibility and process your Medicare claim. You should be aware that the Medicare program specifically excludes payment for certain items and services, such as cosmetic surgery, some oral surgery procedures, personal comfort items, hearing evaluations and others. Deductibles and co-payments are also the responsibility of the patient.


If You Are Covered by Medicaid

We will need a copy of your Medicaid card. Medicaid also has payment limitations on a number of services and items. Medicaid does not pay for the cost of a private room unless medically necessary.


If You Have No Insurance

A representative from the Business Office will discuss financial arrangements with you. Assistance is available to you in applying for Medicaid or other government assistance programs. If payment in full cannot be made at the time of service, Mary Rutan Hospital’s Business Office has special account representatives available to discuss payment options with you.


Your Hospital Bill

The hospital submits bills to your insurance company and will do everything possible to expedite your claim. But you should remember that your policy is a contract between you and your insurance company and you have the final responsibility for payment of your hospital bill. If Mary Rutan Hospital does not receive payment from your insurance company within 30 days, or your insurance company denies your claim, you will receive a statement with the balance due within 10 days. If you do not have insurance, you will receive a bill within 30 days of your discharge date.

If you have certain tests or treatments in the hospital, you may receive additional statements from the following physician specialty groups affiliated with our hospital. These charges are not part of your hospital bill. If you have any questions regarding your account with these groups, please contact them directly. (See reverse.)


Financial Assistance

If you are uninsured and need help with paying your hospital bill, you may qualify for one of our financial assistance programs. These programs are designed to assist patients who are either financially or medically unable to fully pay for their hospital services.

By simply filling out an application and confidentially providing a form of income verification, we can best assist you in possible options.

Applications for financial assistance can be obtained from the registration area, are available on our website or by contacting the Business Office. Once completed, return the application to registration or the Business Office for review.


Billing Addresses:

Anesthesiology
Medical Billing Systems
P.O. Box 341
1046 South Main Street
Bellefontaine, Ohio 43311
(937) 592-9545
Dr. Ferdinand Santos


Cardiology
OSU Cardiology Associates of Bellefontaine
3900 Stoneridge Lane
Dublin, Ohio 43017
(614) 798-7905
Dr. Evan W. Dixon
Dr. Rodney C. Graber
Dr. William A. Houser


Pathology
The Pathology Center, Inc.
P.O. Box 477
Bellefontaine, Ohio 43311
(800) 759-4880
Dr. Robert H. Davis


Pediatric Cardiology
Children’s Hospital Section of Cardiology
700 Children’s Drive
Columbus, Ohio 43205
(614) 722-6682
Dr. Hugh D. Allen
Dr. Curt J. Daniels
Dr. Douglas W. Teske


Radiology
Bellefontaine Radiologists Associates
4132 Elida Rd.
Lima, Ohio 45807
(800) 444-3387


2012 Price List